When a child has psychological problems, what determines whether adults will consider the problems serious or whether they will seek professional help? One determinant may be cultural: Prevailing social values may help set adult thresholds for concern over child problems. We explored this possibility, comparing adults in Thailand and the United States, two countries where social values and perspectives on childhood differ markedly. Thai and American parents, teachers, and clinical psychologists made judgments about two children, one with overcontrolled problems (e.g., shyness, fear) and one with undercontrolled problems (e.g., disobedience, fighting). Consistent with some of the literature on Thai Buddhist values, Thais (compared with Americans) rated problems of both types as less serious, less worrisome, less likely to reflect personality traits, and more likely to improve with time. Cross-national differences in perceived seriousness were more pronounced for parents and teachers than for psychologists, suggesting that professional culture may mitigate the effects of national culture. Evidently, adults' judgments about child clinical problems can differ markedly as a function of their cultural context. So much of our research on psychopathology is based in the West, particularly in North America, that we risk what Kennedy, Scheirer, and Rogers (1984) called a "monocultural science." This risk is significant because research on psychopathology is both the study of the actual behavior of individuals and the study of the lens through which society views that behavior. Because identical behavior is often viewed differently in different societies, judgments about whether a particular behavior pattern represents a serious problem or pathology may be shaped by the cultural context in which the behavior occurs. This phenomenon warrants special attention in research on child psychopathology. In contrast to adults, children rarely consider themselves disturbed and rarely refer themselves for treatment. Instead, parents, teachers, and mental health professionals play these roles, serving, in effect, as gatekeepers to child mental health care. Consequently, the degree of distress adults The study was supported through Grant 5 501 MH38240 from the National Institute of Mental Health, which we acknowledge with gratitude. We thank Elizabeth Barbee, Russell Proops, Suporn Pan, and Suwattana Sripuenpol for their assistance with data collection and reduction as well as Lauren White, whose own research helped to stimulate the present study. Finally, we thank the parents, staff, teachers, and psychologists who participated in the project for the time and thought they invested.

Methods: A Choosing Wisely Working Group of 10 AAN members was formed to oversee the process and craft the evidence-based recommendations. AAN members were solicited for recommendations, the recommendations were sent out for external review, and the Working Group members (article authors) used a modified Delphi process to select their Top Five Recommendations. Results and recommendations:The Working Group submitted 5 neurologic recommendations to the AAN Practice Committee and Board of Directors; all 5 were approved by both entities in September 2012. Recommendation 1: Don't perform EEGs for headaches. Recommendation 2: Don't perform imaging of the carotid arteries for simple syncope without other neurologic symptoms. Recommendation 3: Don't use opioids or butalbital for treatment of migraine, except as a last resort. Recommendation 4: Don't prescribe interferon-b or glatiramer acetate to patients with disability from progressive, nonrelapsing forms of multiple sclerosis. Recommendation 5: Don't recommend carotid endarterectomy for asymptomatic carotid stenosis unless the complication rate is low (,3%). Alzheimer disease, Parkinson disease, stroke, and multiple sclerosis affect approximately 15 million people and account for more than $290 billion in health care spending annually in the United States.